China's Hand-Foot-and-Mouth Disease: Legitimate Threat, or Unnecessary Media Frenzy?

From SARs to bird flu, China's had its fair share of medical scares.  Now a new outbreak of hand-foot-and-mouth disease (HFMD) has caused a new wave of panic nationwide.  Nationwide, nearly seventeen thousand children have been diagnosed with this highly contagious disease this year, and 28 have died from it, according to the latest numbers. 

Officials say things are under control and that it won't be a threat to the Olympics, but China's not always the most transparent country when it comes to infectious diseases.  So what's really going on?

First of all, HFMD isn't some new and mysterious exotic disease.  It's about as threatening as a chicken pox.  According to the Mayo Clinic description, it's mild and highly contagious, causing sores in the mouth, and a rash on the hands and feet.  Young children are most prone to spreading the disease, and it clears up on its own in about 7 to 10 days. 

While I do not have a medical background, from a health perspective alone, it doesn't really make much sense that China's hand-foot-and-mouth disease would receive so much medical attention.  When you compare this disease with many others, it's fairly innocuous, especially considering in the U.S. alone, chicken pox affects four million people, including 100 deaths.

So how does the media handle its reporting of this situation?  Here are a few headlines:

From the Associated Press: China urges precautions against deadly virus

From the Agence-France Press: China urges authorities to step up education of deadly disease

From the International Herald Tribune: China orders mandatory reporting of all cases of deadly virus sickening young children

From the Times Online: More children forecast to die from foot-and-mouth disease in China

It would be one thing if this were a new disease with a lot of variables enshrouded in mystery.  That's not the case, however, and I hardly think that a disease with a fatality rate of about 0.17% this year classifies as a "deadly disease."  Last year, only 17 of China's 80,000 reported cases were fatal, which would lower the percentage even more to .02%.

Of course, the media angle hasn't just been medical: it's political.  Much of the attention hasn't been on the disease itself, but how China's leaders and the Ministry of Health has been responded to it.

In Hong Kong and Singapore, where HFMD is also fairly common, press releases about it are plentiful.  By contrast, China has been less than forthcoming about information, especially in connection with a rare strain of the virus in Anhui Province. 

As the Wall Street Journal's China Journal points out, many domestic media outlets, including the Beijing News severly criticized the Chinese government for its lack of transparency and inaction regarding HFMD before it captured the interest of the international press.

Granted, some of the underreporting of HFMD cases might be due to a unique strain of the virus that didn't contain the usual systems.  Some doctors might have misidentified it as pneumonia, according to Hans Troedssen of the WHO. 

Critics remain convinced of a SARs-like cover-up, but considering this is a fairly common, mild disease, a legitimate malicious cover-up is highly unlikely. 

On Monday, there were only about 5,000 cases reported, which has been modified to 16,778 today.  Naturally, the over 11,000 cases didn't just happen overnight, and there are probably thousands more unreported cases. 

To remedy the problem, China has instituted new measures to report hand-foot-and-mouth disease, which the WHO has endorsed.  These new efforts include increased education about hand-washing and better hygiene,  which helps in controlling the disease.  More importantly, as of yesterday, China requires doctors to report instances of HFMD to the Ministry of Health within 24 hours.  Even with these measures, however, Chinese officials expect an exceptionally high number of cases of the disease this year. 

While Chinese leadership may have covered up the number of HFMD cases, the media frenzy around it has also helped to distort the truth, turning a fairly common disease into a "deadly virus." 

Despite the shortcomings of both parties, the government-media friction has ultimately had a constructive outcome, with a more transparent Ministry of Health and improved health education.